The shortage of organs for transplantation.
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Coroners and Medical Examiners↗
Biomedical subjects
J L Luke
Publications and source records attributed to J L Luke.
The perils of investigating and certifying deaths in police custody.
Procedures leading to the proper investigation and certification of deaths occurring in police custody are discussed. The importance of training and experience, of interchange of information between investigator and forensic pathologist, and of common sense in the pursuit of fairness toward this end is emphasized.
Asphyxia↗
Sudden cardiac death during exercise in a weight lifter using anabolic androgenic steroids: pathological and toxicological findings.
A 21-year-old, previously healthy weight lifter collapsed during a bench press workout. He had taken anabolic androgenic steroids parenterally for the previous several months. Pertinent autopsy findings included marked cardiac and renal hypertrophy and hepatosplenomegaly, with regional myocardial fibrosis and focal myocardial necrosis. Nandrolone (19-nor-testosterone) metabolites were identified in postmortem urine. The possible etiologies of the cardiac findings are discussed.
Adult↗
An alternative diagnosis.
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Embolism, Air↗
Sucking action of the left ventricle: demonstration of a physiologic principle by a gunshot wound penetrating only the right side of the heart.
This report describes a man who died after a gunshot wound that entered the right atrium and exited from the right ventricle without entering the cardiac septa or the left side of the heart. At necropsy, the left atrial appendage was found to be inverted and invaginated into the mitral orifice. The invagination of the left atrial appendage is viewed as anatomic evidence that a negative left ventricular pressure was created as the left ventricular volume rapidly decreased as a result of right-sided cardiac exsanguination. Previously reported experiments in animals demonstrating the sucking (negative pressure) action of the left ventricle during ventricular diastole are summarized. The prerequisite for creation of a negative pressure in the ventricles during diastole is an extreme diminution in left ventricular volume, in this case as a result of right-sided cardiac bleeding. Only a vacuum effect of the left ventricle during diastole can explain the inversion and invagination of the left atrial appendage in this patient.
Adult↗
Sleeping arrangements of sudden infant death syndrome victims in the District of Columbia--a preliminary report.
The recent decline in the incidence of the SIDS in the District of Columbia has permitted identification of what appears to be two separate groups of cases within the generic SIDS population. While deaths of bed-sharing victims remained relatively constant throughout the study period, a greater than fourfold decrease was seen in non-bed-sharing SIDS fatalities. The implications and preliminary nature of these findings are discussed in an attempt to stimulate further inquiry into the possible safety hazard of the practice of bed-sharing in the SIDS age group and its potential influence on the incidence of the SIDS.
Cohort Studies↗
Alcohol-associated deaths in the District of Columbia--a postmortem study.
Ethyl alcohol and its lethal effects were present either in the victim or in the environment, including persons responsible for a given death, in 53% of the cases autopsied during a six-month period at the Office of the Chief Medical Examiner in the District of Columbia. The results of this small, admittedly biased, sample indicate that the acute and chronic effects of alcohol are a major public health problem in this jurisdiction. Comparative figures from other medical examiner's systems suggest the national prevalence of the problem and confirm the gross inadequacy of data from death certificates for such research. Only when the combination of accurate pathological, toxicological, and historical information concerning all types of deaths is available can reliable statistics regarding the numbers and types of deaths related to alcohol be obtained.
Accidents↗